After the AtroPen® (atropine) Auto-injector has been activated, the empty container
should be disposed of properly (see DOSAGE AND ADMINISTRATION). It cannot
be refilled, nor can the protruding needle be retracted.

Atropine, an anticholinergic agent (muscarinic antagonist), occurs as white
crystals, usually needle-like, or as a white, crystalline powder. It is highly
soluble in water with a molecular weight of 289.38. Atropine, a naturally occurring
belladonna alkaloid, is a racemic mixture of equal parts of d- and l-hyoscyamine,
whose activity is due almost entirely to the levo isomer of the drug. Chemically,
atropine is designated as 1 H,5 H-Tropan-3 –ol (±) -tropate. Its empirical formula
is C17H23NO3 and its structural formula is:

For Consumers

What are the precautions when taking atropine (Atropen)?

INDICATIONS

The AtroPen® (atropine) Auto-injector is indicated for the treatment of poisoning
by susceptible organophosphorous nerve agents having cholinesterase activity
as well as organophosphorous or carbamate insecticides. The AtroPen (atropine) auto-injector
should be used by persons who have had adequate training in the recognition
and treatment of nerve agent or insecticide intoxication. Pralidoxime chloride
may serve as an important adjunct to atropine therapy.

The AtroPen® (atropine) is intended as an initial treatment of the muscarinic symptoms
of insecticide or nerve agent poisonings (generally breathing difficulties due
to increased secretions); definitive medical care should be sought immediately.
The AtroPen® (atropine) Auto-injector should be administered as soon as symptoms of
organophosphorous or carbamate poisoning appear (usually tearing, excessive
oral secretions, wheezing, muscle fasciculations, etc.) In moderate to severe
poisoning, the administration of more than one AtroPen® (atropine) may be required
until atropinization is achieved (flushing, mydriasis, tachycardia, dryness
of the mouth and nose). (See DOSAGE AND ADMINISTRATION) In severe poisonings,
it may also be desirable to concurrently administer an anticonvulsant if seizure
is suspected in the unconscious individual since the classic tonic-clonic jerking
may not be apparent due to the effects of the poison. In poisonings due to organophosphorous
nerve agents and insecticides it may also be helpful to concurrently administer
a cholinesterase reactivator such as pralidoxime chloride.

DOSAGE AND ADMINISTRATION

CAUTION! PRIMARY PROTECTION AGAINST EXPOSURE TO CHEMICAL NERVE AGENT AND
INSECTICIDE POISONING IS THE WEARING OF PROTECTIVE GARMENTS INCLUDING MASKS,
DESIGNED SPECIFICALLY FOR THIS USE.

INDIVIDUALS SHOULD NOT RELY SOLELY UPON THE AVAILABILITY OF ANTIDOTES SUCH
AS ATROPINE AND PRALIDOXIME TO PROVIDE COMPLETE PROTECTION FROM CHEMICAL NERVE
AGENT AND INSECTICIDE POISONING.

Immediate evacuation from the contaminated environment is essential. Decontamination
of the poisoned individual should occur as soon as possible.

The AtroPen® (atropine) Auto-injector is indicated for the treatment of poisoning
by susceptible organophosphorous nerve agents having cholinesterase activity
as well as organophosphorous or carbamate insecticides. The AtroPen® (atropine)
auto-injector should be used by persons who have had adequate training in the
recognition and treatment of nerve agent or insecticide intoxication. Pralidoxime
chloride may serve as an important adjunct to atropine therapy.

The AtroPen® (atropine) is intended as an initial treatment of the muscarinic symptoms
of insecticide or nerve agent poisonings (generally breathing difficulties due
to increased secretions); definitive medical care should be sought immediately.
The AtroPen® (atropine) Auto-injector should be administered as soon as symptoms of
organophosphorous or carbamate poisoning appear (usually tearing, excessive
oral secretions, wheezing, muscle fasciculations, etc.) In moderate to severe
poisoning, the administration of more than one AtroPen® (atropine) may be required
until atropinization is achieved (flushing, mydriasis, tachycardia, dryness
of the mouth and nose). In severe poisonings, it may also be desirable to concurrently
administer an anticonvulsant if seizure is suspected in the unconscious individual
since the classic tonic-clonic jerking may not be apparent due to the effects
of the poison. In poisonings due to organophosphorous nerve agents and insecticides
it may also be helpful to concurrently administer a cholinesterase reactivator
such as pralidoxime chloride.

It is recommended that three (3) AtroPen® (atropine) auto-injectors be available for
use in each person at risk for nerve agent or organophosphate insecticide poisoning;
one (1) for mild symptoms plus two (2) more for severe symptoms as described
below. No more than three (3) AtroPen® (atropine) injections should be used unless
the patient is under the supervision of a trained medical provider. Different
dose strengths of the AtroPen® (atropine) are available depending on the recipient's
age and weight.

Adults and children weighing over 90 lbs (generally over 10 years of age)..............AtroPen® (atropine)
2 mg (green)

NOTE: Children weighing under 15 lbs (generally younger than 6 months
old) should ordinarily not be treated with the AtroPen® auto-injector.
Atropine doses for these children should be individualized at doses of 0.05
mg/kg.

Treatment of MILD SYMPTOMS

One (1) AtroPen® (atropine) is recommended if two or more MILD symptoms of
nerve agent (nerve gas) or insecticide exposure appear in situations where exposure
is known or suspected.

Two (2) additional AtroPen® (atropine) injections given in rapid succession
are recommended 10 minutes after receiving the first AtroPen® (atropine) injection
if the victim develops any of the SEVERE symptoms listed below. If possible,
a person other than the victim should administer the second and third AtroPen® (atropine)
injections.

Treatment of SEVERE SYMPTOMS:

If a victim is encountered who is either unconscious or has any of the SEVERE
symptoms listed below, immediately administer three (3) AtroPen® (atropine)
injections into the victim's mid-lateral thigh in rapid succession using the
appropriate weight-based AtroPen® (atropine) dose.

MILD SYMPTOMS of nerve agent or insecticide exposure include the following:

All victims should be evacuated immediately from the contaminated environment. Medical help should be sought immediately. Protective masks and clothing should be used when available. Decontamination procedures should be undertaken as soon as possible. If dermal exposure has occurred, clothing should be removed and the hair and skin washed thoroughly with sodium bicarbonate or alcohol as soon as possible.

Emergency care of the severely poisoned individual should include removal of
oral and bronchial secretions, maintenance of a patent airway, supplemental
oxygen and, if necessary, artificial ventilation. In general, atropine should
not be used until cyanosis has been overcome since atropine may produce ventricular
fibrillation and possible seizures in the presence of hypoxia.

Pralidoxime (if used) is most effective if administered immediately or soon after the poisoning. Generally, little is accomplished if pralidoxime is given more than 36 hours after termination of exposure unless the poison is known to age slowly or re-exposure is possible, such as in delayed continuing gastrointestinal absorption of ingested poisons. Fatal relapses, thought to be due to delayed absorption, have been reported after initial improvement. Continued administration for several days may be useful in such patients.

Close supervision of all moderately to severely poisoned patients is indicated for at least 48 to 72 hours.

An anticonvulsant such as diazepam may be administered to treat convulsions if suspected in the unconscious individual. The effects of nerve agents and some insecticides can mask the motor signs of a seizure.

Instructions for administering AtroPen® (atropine) (please refer to the illustrated
Self Aid and Caregiver Directions for Use elsewhere):

Warning: Giving additional AtroPen® (atropine) injections by mistake in the absence
of actual nerve agent or insecticide poisoning may cause an overdose of atropine
which could result in temporary incapacitation (inability to walk properly,
see clearly or think clearly for several or more hours). Patients with cardiac
disease may be at risk for serious adverse events, including death.

SIDE EFFECTS

The major and most common side effects of atropine can be attributed to its
antimuscarinic action. These include dryness of the mouth, blurred vision, photophobia,
confusion, headache, dizziness, tachycardia, palpitations, flushing, urinary
hesitance or retention, constipation, abdominal distention, nausea, vomiting,
loss of libido and impotency. Anhidrosis may produce heat intolerance and impairment
of temperature regulation especially in a hot environment. Larger or toxic doses
may produce such central effects as restlessness, tremor, fatigue, locomotor
difficulties, delirium, followed by hallucinations, depression and ultimately,
medullary paralysis and death. Large doses can also lead to circulatory collapse.
In such cases, blood pressure declines and death due to respiratory failure
may ensue following paralysis and coma. Hypersensitivity reactions will occasionally
occur with atropine: these are usually seen as skin rashes, on occasion progressing
to exfoliation. Adverse events seen in pediatrics are similar to those that
occur in adult patients although central nervous system complaints are often
seen earlier and at lower doses.

When atropine and pralidoxime are used together, the signs of atropinization may occur earlier than might be expected than when atropine is used alone. This is especially true if the total dose of atropine has been large and the administration of pralidoxime has been delayed. Excitement and manic behavior immediately following recovery of consciousness have been reported in several cases. However, similar behavior has occurred in cases of organophosphate poisoning that were not treated with pralidoxime.

Amitai et el (JAMA 1990) evaluated the safety of AtroPen® (atropine) 0.5 mg, 1 mg and 2 mg in a case series of 240 children who received AtroPen® (atropine) inappropriately (i.e., no nerve agent exposure) during the 1990 Gulf War Period. Overall, severity of atropinization followed a nonlinear correlation with dose. Estimated doses up to 0.045 mg/kg produced no signs of atropinization. Estimated doses between 0.045 mg/kg to 0.175 mg/kg and even greater than 0.175 mg/kg were associated with mild and severe effects respectively. Actual dosage received by children may have been considerably lower than estimated since incomplete injection in many cases was suspected. Regardless, adverse events reported were generally mild and self-limited. Few children required hospitalization. Adverse reactions reported were dilated pupils (43%), tachycardia (39%), dry membranes (35%), flushed skin (20%), temperature 37.8° C or 100° F (4%) and neurologic abnormalities (5%). There was also local pain and swelling. In 91 children with ECGs, no abnormalities were noted other than sinus tachycardia; 22 children had severe tachycardia of 160-190 bpm. Neurologic abnormalities consisted of irritability, agitation, confusion, lethargy, and ataxia.

The following adverse reactions were reported in published literature for atropine in both adults and children:

Drug Abuse And Dependence

Atropine possesses no known potential for dependence.

DRUG INTERACTIONS

When atropine and pralidoxime are used together, the signs of atropinization
(flushing, mydriasis, tachycardia, dryness of the mouth and nose) may occur
earlier than might be expected than when atropine is used alone because pralidoxime
may potentiate the effect of atropine.

The following precautions should be kept in mind in the treatment of anticholinesterase poisoning although they do not bear directly on the use of atropine and pralidoxime. Since barbiturates are potentiated by the anticholinesterases, they should be used cautiously in the treatment of convulsions.

Warnings & Precautions

WARNINGS

CAUTION! PRIMARY PROTECTION AGAINST EXPOSURE TO CHEMICAL NERVE AGENTS AND
INSECTICIDE POISONING IS THE WEARING OF PROTECTIVE GARMENTS INCLUDING MASKS
DESIGNED SPECIFICALLY FOR THIS USE.

INDIVIDUALS SHOULD NOT RELY SOLELY UPON ANTIDOTES SUCH AS ATROPINE AND PRALIDOXIME
TO PROVIDE COMPLETE PROTECTION FROM CHEMICAL NERVE AGENTS AND INSECTICIDE POISONING.

Patients who have had previous anaphylactic reactions to atropine who have mild symptoms of organophosphorous or nerve agent poisoning should not be treated without adequate medical supervision.

While AtroPen® (atropine) can be administered to all individuals with a life-threatening exposure to organophosphorous nerve agents and insecticides, it should be administered with extreme caution to individuals with the following disorders when the symptoms of nerve agent poisoning are less severe: individuals who are hypersensitive to any component of the product, disorders of heart rhythm such as atrial flutter, severe narrow angle glaucoma, pyloric stenosis, prostatic hypertrophy, significant renal insufficiency, or a recent myocardial infarction.

More than one dose of atropine (AtroPen® (atropine) Auto-injector) may be necessary
initially, especially when exposure is massive or symptoms are severe. However,
no more than three doses should be administered unless under the supervision
of trained medical personnel. High doses of atropine may be required for
many hours following high-dose exposure to maintain atropinization. (See DOSAGE
AND ADMINISTRATION.)

Children and the elderly may be more susceptible to the pharmacologic effects of atropine.

Severe difficulty in breathing requires artificial respiration in addition to the use of atropine since atropine is not dependable in reversing the weakness or paralysis of the respiratory muscles.

PRECAUTIONS

General

The desperate condition of the organophosphorous-poisoned individual will generally
mask such minor signs and symptoms of atropine treatment as have been noted
in normal subjects.

Atropine should be used with caution in individuals with cardiac disease. Conventional systemic doses may precipitate acute glaucoma in susceptible individuals, convert partial pyloric stenosis into complete pyloric obstruction, precipitate urinary retention in individuals with prostatic hypertrophy, or cause inspissation of bronchial secretions and formation of dangerous viscid plugs in individuals with chronic lung disease.

Laboratory Tests

Treatment of organophosphorous nerve agent and insecticide poisoning should
be instituted without waiting for the results of laboratory tests. Red blood
cell and plasma cholinesterase, and urinary paranitrophenol measurements (in
the case of parathion exposure) may be helpful in confirming the diagnosis and
following the course of the illness. A reduction in red blood cell cholinesterase
concentration to below 50% of normal has been seen only with organophosphorous
ester poisoning.

Information for Patients

Appropriate steps must be taken to insure that users understand the indications
for and use of the AtroPen® (atropine) , including review of symptoms of poisoning and
operation of the AtroPen® (see DOSAGE AND ADMINISTRATION).

Carcinogenesis, Mutagenesis, Impairment of Fertility

No reports regarding the potential of atropine for carcinogenesis, mutagenesis,
or impairment of fertility have been published in the literature. Since atropine
is indicated for short-term emergency use only, no investigations of these aspects
have been conducted.

Pregnancy

Teratogenic Effects – Pregnancy Category C: Adequate
animal reproduction studies have not been conducted with atropine. It is not
known whether atropine can cause fetal harm when administered to a pregnant
woman or if these agents can affect reproductive capacity. Atropine should be
administered to a pregnant woman only if clearly needed.

Nursing Mothers

Atropine is found in human milk in trace amounts. Caution should be exercised
when atropine is administered to a nursing woman.

Pediatric Use

A review of published literature supports the safety and effectiveness of atropine
in the setting of organophosphate insecticide poisoning in all pediatric age
groups. The starting dose is 0.05 mg/kg IM every 5 to 20 minutes as needed to
provide complete atropinization. (seeADVERSE REACTIONS
and DOSAGE AND ADMINISTRATION sections)

Geriatric Use

In general, dose selection for an elderly individual should be cautious, usually
starting at the low end of the dosing range, reflecting the greater frequency
of decreased hepatic, renal, or cardiac function, and of concomitant disease
or other drug therapy.

Overdosage & Contraindications

OVERDOSE

Symptoms

Serious overdosage with atropine is characterized by widespread paralysis of parasympathetically innervated organs. Dry mucous membranes, widely dilated and nonresponsive pupils, tachycardia, fever and cutaneous flush are especially prominent, as are mental and neurological symptoms. Disorientation, mania, hallucinations, gait disturbances and symptoms may last 48 hours or longer. In instances of severe intoxication, respiratory depression, coma, circulatory collapse and death may occur.

The fatal dose of atropine is not known. In the treatment of organophosphorous poisoning, cumulative doses of approximately 2300-3300 mg or more have been administered over several days to 4-5 weeks. In children, medical literature published prior to 1951 reports four deaths, all in patients 10 months to 3 years of age, and all associated with atropine eye drops or ointment. Total estimated ophthalmic doses were 1.6, 2, 4, and 18 mg given as a single dose (2 mg) or over 1-2 days. Review of current published literature since 1950 identified no pediatric deaths associated with atropine. The few deaths in adults were generally seen using typical clinical doses of atropine often in the setting of bradycardia associated with an acute myocardial infarction.

With a dose as low as 0.5 mg, undesirable symptoms or responses of overdosage may occur. These increase in severity and extent with larger doses of the drug (excitement, hallucinations, delirium and coma). Extreme hyperthermia in a newborn has been reported with as little as 0.065 mg orally. However, in the presence of organophosphorous poisoning, much higher doses of atropine appear to be tolerated and required for optimal therapy.

Treatment

Supportive treatment should be administered as indicated. If respiration is depressed, artificial respiration with oxygen is necessary. Ice bags, alcohol sponges or a hypothermia blanket may be required to reduce fever, especially in children. Catheterization may be necessary if urinary retention occurs. Since atropine elimination takes place through the kidney, output must be maintained and increased if possible, however, dialysis has not been shown to be helpful in overdose situations. Intravenous fluids may be indicated. Because of the affected person's photophobia, the room should be darkened.

In the event of toxic overdosage, a short-acting barbiturate or diazepam may be given as needed to control marked excitement and convulsions. Large doses for sedation should be avoided because central depressant action may coincide with the depression occurring late in atropine poisoning. Central stimulants are not recommended. Physostigmine, given as an atropine antidote by slow intravenous injection of 1 to 4 mg (0.5 to 1.0 mg in children), rapidly abolishes delirium and coma caused by large doses of atropine in most situations. Since physostigmine has a short duration of action, the patient may again lapse into coma after one or two hours and repeated doses are likely to be required. Neostigmine, pilocarpine and methacholine are of little real benefit, since they do not penetrate the blood-brain barrier.

CONTRAINDICATIONS

In the face of life-threatening poisoning by organophosphorous nerve agents
and insecticides, there are no absolute contraindications for the use of atropine
(see WARNINGS).

Clinical Pharmacology

CLINICAL PHARMACOLOGY

Mechanism of Action

Atropine is commonly classified as an anticholinergic or antiparasympathetic (parasympatholytic) drug. More precisely, however, it is termed an antimuscarinic agent since it antagonizes the muscarine-like actions of acetylcholine and other choline esters.

Atropine inhibits the muscarinic actions of acetylcholine on structures innervated by postganglionic cholinergic nerves, and on smooth muscles, which respond to endogenous acetylcholine but are not so innervated. As with other antimuscarinic agents, the major action of atropine is a competitive or surmountable antagonism, which can be overcome by increasing the concentration of acetylcholine at receptor sites of the effector organ (e.g., by using anticholinesterase agents, which inhibit the enzymatic destruction of acetylcholine). The receptors antagonized by atropine are the peripheral structures that are stimulated or inhibited by muscarine, (i.e., exocrine glands and smooth and cardiac muscle). Responses to postganglionic cholinergic nerve stimulation may also be inhibited by atropine, but this occurs less readily than with responses to injected (exogenous) choline esters.

Pharmacodynamics

Atropine reduces secretions in the mouth and respiratory passages, relieves the constriction and spasm of the respiratory passages, and may reduce the paralysis of respiration, which results from actions of the toxic agent on the central nervous system. Atropine-induced parasympathetic inhibition may be preceded by a transient phase of stimulation, especially on the heart where small doses first slow the rate before characteristic tachycardia develops due to paralysis of vagal control. Although mild vagal excitation occurs, the increased respiratory rate and occasionally increased depth of respiration produced by atropine are more probably the result of bronchiolar dilatation. Accordingly, atropine is an unreliable respiratory stimulant and large or repeated doses may depress respiration.

Adequate doses of atropine abolish various types of reflex vagal cardiac slowing or asystole. The drug also prevents or abolishes bradycardia or asystole produced by injection of choline esters, anticholinesterase agents or other parasympathomimetic drugs, and cardiac arrest produced by stimulation of the vagus. Atropine may also lessen the degree of partial heart block when vagal activity is an etiologic factor. In some individuals with complete heart block, the idioventricular rate may be accelerated by atropine; in others, the rate is stabilized. Occasionally, a large dose may cause atrioventricular (A-V) block and nodal rhythm.

Atropine in clinical doses counteracts the peripheral dilatation and abrupt decrease in blood pressure produced by choline esters. However, when given by itself, atropine does not exert a striking or uniform effect on blood vessels or blood pressure. Systemic doses slightly raise systolic and lower diastolic pressures and can produce significant postural hypotension. Such doses also slightly increase cardiac output and decrease central venous pressure. Occasionally, therapeutic doses dilate cutaneous blood vessels, particularly in the "blush" area (atropine flush), and may cause atropine "fever" due to suppression of sweat gland activity especially in infants and small children.

Pharmacokinetics

Atropine is rapidly and well absorbed after intramuscular administration. Atropine disappears rapidly from the blood and is distributed throughout the various body tissues and fluids. Much of the drug is destroyed by enzymatic hydrolysis, particularly in the liver; from 13 to 50% is excreted unchanged in the urine. Traces are found in various secretions, including milk. Atropine readily crosses the placental barrier and enters the fetal circulation.

The approximate Cmax of atropine following 1.67 mg atropine given intramuscularly
to adults by the 2 mg AtroPen® (atropine) delivery system was 9.6 ± 1.5 (mean ± SEM)
ng/ml. The mean T max was 3 minutes. The T½ of intravenous atropine in pediatric
subjects under 2 years is 6.9 ± 3.3 (mean ± SD) hours; in children over 2 years,
the T½ is 2.5 ± 1.2 (mean ± SD) hours; in adults 16–58 years the T½ is 3.0 ±
0.9 (mean ± SD) hours; in geriatric patients 65–75 years it is 10.0 ± 7.3 (mean
± SD) hours. The protein binding of atropine is 14 to 22% in plasma. There are
gender differences in the pharmacokinetics of atropine. The AUC(0-inf) and Cmax
were 15% higher in females than males. The half-life of atropine is slightly
shorter (approximately 20 minutes) in females than males.

Medication Guide

PATIENT INFORMATION

Self-Aid and Caregiver Aid Directions for Use.

FOLLOW THESE INSTRUCTIONS ONLY WHEN READY TO ADMINISTER ATROPINE

Step 1

USE THE CORRECT DOSE

Adults and children weighing over 90 lbs
(generally over 10 years of age)
2 mg AtroPen® (atropine)
(GREEN LABEL)

NOTE: Children weighing under 15 lbs (generally younger
than 6 months old) should ordinarily not be treated with the AtroPen®
auto-injector. Atropine doses in this age group should be individualized
at doses of 0.05 mg/kg.

Step 2

KNOW NERVE AGENT AND INSECTICIDE POISONING SYMPTOMS

In an environment where nerve agent (or nerve gas) or insecticide exposure
is known or
suspected, the following are mild and severe symptoms of nerve agent intoxication.
You may not have all of these symptoms:

FIRST DOSE: Give one (1) AtroPen® (atropine) if you experience
two or more MILD symptoms of nerve gas or insecticide exposure. Look
for a helper and have them check you for continued or worsening symptoms.
Get medical attention immediately.ADDITIONAL DOSES: Two (2) additional AtroPen® (atropine) injections given
in rapid succession are recommended 10 minutes after receiving the first
AtroPen® (atropine) injection if the victim develops any of the SEVERE
symptoms listed above. If possible, a person other than the victim should
administer the second and third AtroPen® (atropine) injections.

TREATMENT OF SEVERE SYMPTOMS

If a victim is encountered who is either unconscious or
has any of the SEVERE symptoms listed above, immediately administer
three (3) AtroPen® (atropine) injections into the victim's mid-lateral
thigh in rapid succession using the appropriate weight-based AtroPen® (atropine)
dose.WARNING: Giving additional AtroPen (atropine) 0 injections by mistake
in the absence of nerve agent or insecticide poisoning may cause an overdose
of atropine which might result in temporary incapacitation (inability
to see clearly or walk properly for several or more hours). Patients with
cardiac disease may be at risk for serious adverse events, including death.

Step 4

DIRECTIONS FOR THE USE OF THE ATROPEN® (atropine) #00001

(A) Snap the grooved end of the plastic sleeve down and over the yellow
safety cap. Remove the AtroPen® (atropine) from the plastic sleeve.Caution: Do not place fingers on green tip.

(B) Firmly grasp the AtroPen® with the green tip pointed down.

(C) Pull off the yellow safety cap with your other hand.

(D) Aim and firmly jab the green tip straight down (a 90° angle)
against the outer thigh. The AtroPen® (atropine) device will activate and deliver
the medicine when you do this. It is okay to inject through clothing
but make sure pockets at the injection site are empty.
Very thin people and small children should also be injected in the thigh,
but before giving the AtroPen® (atropine) , bunch up the thigh to provide a thicker
area for injection.

(E) Hold the auto-injector firmly in place for at least 10 seconds to
allow the injection to finish.

(F) Remove the AtroPen® and massage the injection site for several
seconds. If the needle is not visible, check to be sure the yellow safety
cap has been removed, and repeat steps C and E, but press harder.

(G) After use, using a hard surface, bend the needle back against the
AtroPen® (atropine) and either pin the used AtroPen® (atropine) to the victim's clothing
or show the used AtroPen® (atropine) auto-injectors to the first medical person
you see. This will allow medical personnel to see the number and dose
of AtroPen® (atropine) autoinjectors administered. Move yourself and the exposed
individual away from the contaminated area right away.
Try to find medical help.

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.